The Effects of Non-Prescribing of Anxiolytics in General Practice: I. Controlled Evaluation of Psychiatric and Social Outcome

1984 ◽  
Vol 144 (6) ◽  
pp. 593-602 ◽  
Author(s):  
Jose Catalan ◽  
Dennis Gath ◽  
Gillian Edmonds ◽  
John Ennis
Keyword(s):  
General Practice ◽  
General Health Questionnaire ◽  
Drug Group ◽  
Mood States ◽  
Profile Of Mood States ◽  
Health Questionnaire ◽  
Social Outcome ◽  
Controlled Evaluation ◽  
Psychiatric State ◽  
State Examination

SummaryNinety one patients with new episodes of minor affective disorder were selected by their general practitioners as suitable for anxiolytic medication. Half the patients were allocated randomly to a drug-group (anxiolytic medication), and half to a non-drug group (brief counselling without anxiolytics). Psychiatric and social assessments were made (i) at initial consultation when treatment was started; (ii) one month later; (iii) seven months later. Before treatment the two groups were similar on all main variables. On the General Health Questionnaire, 85 per cent of patients were psychiatric cases before treatment, 40 per cent at one month and 30 per cent at seven months. Similar improvements were found with other measures of psychiatric state (Profile of Mood States; Present State Examination) and social functioning (SAS-M). Improvements were similar and parallel in the two groups. Neither group of patients increased their consumption of alcohol, tobacco or non-prescribed drugs. The non-drug group did not make increased demands on the doctors' time.

The Effects of Non-Prescribing of Anxiolytics in General Practice: II. Factors Associated with Outcome

1984 ◽  
Vol 144 (6) ◽  
pp. 603-610 ◽  
Author(s):  
Jose Catalan ◽  
Dennis Gath ◽  
Alison Bond ◽  
Pauline Martin
Keyword(s):  
General Practice ◽  
Life Events ◽  
Outcome Measures ◽  
General Health Questionnaire ◽  
Profile Of Mood States ◽  
Factors Associated ◽  
Psychiatric State ◽  
State Examination ◽  
Psychiatric Outcome

SummaryFactors associated with psychiatric outcome were examined in a series of 87 patients who had presented in general practice with new episodes of minor affective disorder. Two outcome measures were used: (i) Status on Present State Examination (PSE) seven months after initial consultation; (ii) prescribing of psychotropic medication between one-month and seven-month follow-up assessments. Outcome according to the PSE was significantly associated with: worse measures of psychiatric state (General Health Questionnaire, Profile of Mood states) and of social functioning (SAS-M) at initial consultation and one month later; and with persistent anxious or depressed mood during the follow-up period; but not with life events. During the follow-up period 20 patients received at least one psychotropic prescription; they were significantly associated with worse initial GHQ scores, consumption of tobacco and non-prescribed medication, and initial anxiety. A sub-group of 11 patients received multiple psychotropic prescriptions; they were significantly associated with the same initial measures, and also with poor outcome measures (psychiatric and social).

Non-Psychotic Psychiatric Disorder After Childbirth

1988 ◽  
Vol 152 (6) ◽  
pp. 799-806 ◽  
Author(s):  
Peter J. Cooper ◽  
Elizabeth A. Campbell ◽  
Ann Day ◽  
Helen Kennerley ◽  
Alison Bond
Keyword(s):  
Psychiatric Disorder ◽  
Rating Scale ◽  
General Health Questionnaire ◽  
Population Sample ◽  
General Population Sample ◽  
Health Questionnaire ◽  
Psychiatric Disturbance ◽  
Full Sample ◽  
Psychiatric State ◽  
State Examination

The psychiatric state of 483 women was examined antenatally and at 3, 6, and 12 months postpartum. Comprehensive assessments were made of all women antenatally and of subgroups of the full sample postnatally. Psychiatric state was assessed using the General Health Questionnaire, the Present State Examination and the Montgomery and åsberg Depression Rating Scale. In terms of PSE criteria, the point prevalence of non-psychotic psychiatric disorder antenatally was found to be 6.0%; and postnatally it was estimated to be 8.7% at 3 months, 8.8% at 6 months and 5.2% at 12 months after delivery. These prevalence rates were compared to the rate in a general population sample of non-puerperal women and found to be no greater. In a subgroup of the full sample, the incidence of psychiatric disorder in the year following delivery was estimated to be 15.1%, which is close to a figure previously reported for women in the community. The onset of psychiatric disturbance was soon after delivery in most instances; and, for the majority, the episode of disturbance lasted for 3 months or less. The distribution of PSE Catego classes and syndromes among the antenatal and postnatal samples were found to be similar to those in the non-puerperal comparison sample. Thus, the prevalence, incidence, and nature of non-psychotic psychiatric disorder in the 12 months following delivery do not appear to distinguish it from such disorders arising at other times.

Validation of the General Health Questionnaire in a young community sample

1983 ◽  
Vol 13 (2) ◽  
pp. 349-353 ◽  
Author(s):  
Michael H. Banks
Keyword(s):  
General Health ◽  
Community Sample ◽  
General Health Questionnaire ◽  
Continuous Variable ◽  
General Factor ◽  
Health Questionnaire ◽  
Relative Independence ◽  
The Social ◽  
Misclassification Rates ◽  
State Examination

SYNOPSISValidity coefficients of the 30-item, 28-item and 12-item versions of the General Health Questionnaire (GHQ) were determined by comparison with the Present State Examination (PSE) in a sample of 200 17-year-olds. The PSE classified 7 people (3·5%) as cases, although only 47% were identified as free of symptoms. Misclassification rates, sensitivity and specificity values are presented for different cutting scores for the three versions of the GHQ. The GHQ-28 had superior values, especially with a cutting score of 5/6; the GHQ-12 with a 2/3 cutting score also had acceptable values. All versions of the GHQ correlated highly with the PSE Index of Definition and total scores, providing support for the treatment of GHQ scores as a continuous variable in this kind of population. Correlations between sub-scales of the GHQ-28 give further evidence for a general factor and the relative independence of the social dysfunction sub-scale.

A Factor Analytic Study of the 60-Item General Health Questionnaire in Australian Community and General Practice Settings

1984 ◽  
Vol 18 (3) ◽  
pp. 256-262 ◽  
Author(s):  
P. W. Burvill ◽  
M. W. Knuiman ◽  
R. A. Finlay-Jones
Keyword(s):  
General Practice ◽  
General Health ◽  
General Health Questionnaire ◽  
Analytic Study ◽  
Physical Factors ◽  
Positive Finding ◽  
Health Questionnaire ◽  
Factor Analytic ◽  
Factor Analytic Study ◽  
Significant Difference

A factor analytic study of responses to a 60-item General Health Questionnaire of people in general practice and in the community in Perth, Western Australia, was performed. Five identified factors, accounting for 46% of the variance, were very similar to factors identified in an English general practice study but differed from two published Australian studies. The statistic of a relative GHQ profile was generated to compare these factors in various sets of data. There was no significant difference between the relative GHQ profile in the community and general practice data or between demographic factors such as sex, social class and country of birth. The major positive finding was of an excess of overtly psychological factors in ‘cases’ compared with an excess of more physical factors in ‘non-cases’.

Severity of Psychiatric Disorder and the 30-Item General Health Questionnaire

1979 ◽  
Vol 134 (6) ◽  
pp. 609-616 ◽  
Author(s):  
Robert A. Finlay-Jones ◽  
Elaine Murphy
Keyword(s):  
Psychiatric Disorder ◽  
General Health ◽  
General Health Questionnaire ◽  
Health Questionnaire ◽  
False Negatives ◽  
Two Samples ◽  
Threshold Score ◽  
Adverse Life Event ◽  
Chronic Disorders ◽  
State Examination

SummaryThe 30-item General Health Questionnaire misclassified 26 per cent of respondents in two samples of women who were interviewed by a psychiatrist using the Present State Examination. False negatives were likely to be women with chronic disorders, particularly anxiety states. False positives were likely to be distressed by severe physical illness, a recent adverse life event, or loneliness. Applying a higher threshold score to their GHQ, responses would help to separate those with a diagnosable psychiatric disorder from those in states of distress.

Psychiatric Effects of Alternate Day Steroid Therapy

1981 ◽  
Vol 138 (6) ◽  
pp. 504-506 ◽  
Author(s):  
Christopher Cordess ◽  
Marshal Folstein ◽  
Daniel Drachman
Keyword(s):  
Myasthenia Gravis ◽  
Present State ◽  
Steroid Therapy ◽  
General Health ◽  
Neuromuscular Disorders ◽  
General Health Questionnaire ◽  
Emotional Disorder ◽  
Health Questionnaire ◽  
State Examination

SummaryThe prevalence of emotional disorder in a total of 72 patients suffering from myasthenia gravis or from peripheral neuromuscular disorders was assessed, using the General Health Questionnaire and Present State Examination.Approximately half the patients were being treated with an alternate day regime of prednisone, receiving high dosage one day and low the next. Emotional disorder was found to be less prevalent among these patients than among patients not on steroids. The significance of the finding is discussed.

Severity of symptoms of psychiatric outpatients: use of the General Health Questionnaire in hospital and general practice patients

1975 ◽  
Vol 5 (1) ◽  
pp. 62-66 ◽  
Author(s):  
A. C. P. Sims ◽  
P. H. Salmons
Keyword(s):  
General Practice ◽  
General Health ◽  
General Health Questionnaire ◽  
Psychiatric Morbidity ◽  
Control Sample ◽  
Outpatient Service ◽  
Health Questionnaire ◽  
Psychiatric Outpatient ◽  
Screening Device ◽  
Matched Samples

SynopsisA sample of 91 new referrals to a community based psychiatric outpatient service was compared with a cross-matched control sample of 107 patients attending the general practitioner's surgery. The subjects in both groups completed the General Health Questionnaire and there was a very marked difference between the scores of the two groups. Seventy-five of the psychiatric group had a high score on the questionnaire, and a large number of these were extremely high, while 74 of the general practice group had a low score. The ‘false’ positives and negatives are discussed. It is considered that the validity of this questionnaire as a screening device for demonstrating psychiatric morbidity and severity in general practice is further established in this study by showing that in matched samples the expected psychiatric morbidity in general practice can be compared with the much greater morbidity in psychiatric outpatient referrals. For the psychiatric sample more patients showed high scores and these tended to be much higher.

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